目的对比早发型及晚发型发作性睡病患者的临床及电生理检测特点。方法发作性睡病者共105例,其中15岁以下起病的早发型患者63例,平均发病年龄9.7岁±3.1岁;15岁以上起病的晚发型患者42例,平均发病年龄22.8岁±9.3岁。对比分析其...目的对比早发型及晚发型发作性睡病患者的临床及电生理检测特点。方法发作性睡病者共105例,其中15岁以下起病的早发型患者63例,平均发病年龄9.7岁±3.1岁;15岁以上起病的晚发型患者42例,平均发病年龄22.8岁±9.3岁。对比分析其临床、多导生理记录仪及多次小睡睡眠潜伏时间试验(MSLT)结果。结果全部患者均有白天嗜睡。发作性猝倒在早发型患者中发生率为92%,高于晚发型患者的76%(P=0.023);两组患者睡瘫、入睡幻觉及夜间睡眠紊乱的发生率相近(P均>0.05)。MSLT检查发现早发型患者的平均睡眠潜伏期(4.5 m in±4.0 m in及7.0 m in±5.7 m in,P=0.018)和REM睡眠潜伏期(3.4 m in±3.2 m in及4.8 m in±2.2 m in,P=0.02)更短,REM睡眠次数更多(3.4±2.0及2.5±1.9,P=0.009),晚发型患者的AHI次数更多(9.2次±16.5次及1.9次±6.3次,P=0.009),睡眠呼吸障碍较严重。3例有家族史者均为早发型患者。结论早发型发作性睡病患者的嗜睡及猝倒症状及临床特点较晚发型患者典型,其发生可能与遗传因素的关系更密切。展开更多
Modafinil is employed for the treatment of narcolepsy and other sleep disorders like idiopathic hypersornnia. Modafinil is involved in the modulation of orexin, a hypothalamic neuropeptide that regulates wakefulness. ...Modafinil is employed for the treatment of narcolepsy and other sleep disorders like idiopathic hypersornnia. Modafinil is involved in the modulation of orexin, a hypothalamic neuropeptide that regulates wakefulness. It also indicated that the drug interferes with the activity of additional neurotransmitters like hypocretin, histamine, gamma-aminobutyricacid, glutamate and norepinephrine. Modafinil can also block the dopamine transporter by increasing brain dopamine levels. Common side effects of modafinil include headache, nausea, nervousness, anxiety and trouble sleeping. Other side effects are affective lability, hyposexuality, personality change, aggression, abnormal dreams, irritability, suicidal ideas, mania, hypomania and psychotic exacerbation. In this case report, we present a 45 year old woman with idiopathic hypersomnia which is characterized primarily excessive day time sleepiness. Before modafinil treatment ESS （Epworth Sleepiness Scale） score of patient was 13. Treatment with Modafmil 200 mg daily within two weeks produced a subjective improvement in her daytime sleepiness （ESS score after treatment is 4）. But one week after the start of modafmil treatment, her sexual desire increased. Before this treatment, her sexual intercourse frequency was 1-2 times per week and after this treatment she wanted coitus every day. She has continual thoughts about sexuality. She didn＇t have any additional medication use or medical condition that increase sexual desire. Modafinil dose was decreased 100 mg/daythen to 50 mg/day. Her ESS score was 7 and daytime sleepiness had no effect on her life. After decreasing modafinil treatment her sexual desire returned to normal. Hypersexuality has not been reported as a side effect of modafinil yet. The pathophysiological mechanism of modafinil induced hypersexuality is not clear. In conclusion, clinicians should be aware of this rare significant side effect of modafinil and should maintain treatment with the lowest possible dose.展开更多
文摘目的对比早发型及晚发型发作性睡病患者的临床及电生理检测特点。方法发作性睡病者共105例,其中15岁以下起病的早发型患者63例,平均发病年龄9.7岁±3.1岁;15岁以上起病的晚发型患者42例,平均发病年龄22.8岁±9.3岁。对比分析其临床、多导生理记录仪及多次小睡睡眠潜伏时间试验(MSLT)结果。结果全部患者均有白天嗜睡。发作性猝倒在早发型患者中发生率为92%,高于晚发型患者的76%(P=0.023);两组患者睡瘫、入睡幻觉及夜间睡眠紊乱的发生率相近(P均>0.05)。MSLT检查发现早发型患者的平均睡眠潜伏期(4.5 m in±4.0 m in及7.0 m in±5.7 m in,P=0.018)和REM睡眠潜伏期(3.4 m in±3.2 m in及4.8 m in±2.2 m in,P=0.02)更短,REM睡眠次数更多(3.4±2.0及2.5±1.9,P=0.009),晚发型患者的AHI次数更多(9.2次±16.5次及1.9次±6.3次,P=0.009),睡眠呼吸障碍较严重。3例有家族史者均为早发型患者。结论早发型发作性睡病患者的嗜睡及猝倒症状及临床特点较晚发型患者典型,其发生可能与遗传因素的关系更密切。
文摘Modafinil is employed for the treatment of narcolepsy and other sleep disorders like idiopathic hypersornnia. Modafinil is involved in the modulation of orexin, a hypothalamic neuropeptide that regulates wakefulness. It also indicated that the drug interferes with the activity of additional neurotransmitters like hypocretin, histamine, gamma-aminobutyricacid, glutamate and norepinephrine. Modafinil can also block the dopamine transporter by increasing brain dopamine levels. Common side effects of modafinil include headache, nausea, nervousness, anxiety and trouble sleeping. Other side effects are affective lability, hyposexuality, personality change, aggression, abnormal dreams, irritability, suicidal ideas, mania, hypomania and psychotic exacerbation. In this case report, we present a 45 year old woman with idiopathic hypersomnia which is characterized primarily excessive day time sleepiness. Before modafinil treatment ESS （Epworth Sleepiness Scale） score of patient was 13. Treatment with Modafmil 200 mg daily within two weeks produced a subjective improvement in her daytime sleepiness （ESS score after treatment is 4）. But one week after the start of modafmil treatment, her sexual desire increased. Before this treatment, her sexual intercourse frequency was 1-2 times per week and after this treatment she wanted coitus every day. She has continual thoughts about sexuality. She didn＇t have any additional medication use or medical condition that increase sexual desire. Modafinil dose was decreased 100 mg/daythen to 50 mg/day. Her ESS score was 7 and daytime sleepiness had no effect on her life. After decreasing modafinil treatment her sexual desire returned to normal. Hypersexuality has not been reported as a side effect of modafinil yet. The pathophysiological mechanism of modafinil induced hypersexuality is not clear. In conclusion, clinicians should be aware of this rare significant side effect of modafinil and should maintain treatment with the lowest possible dose.
